Changes in cerebral activity after decreased upper-limb hypertonus

An EMG-fMRI study

Paolo Manganotti, Michele Acler, Emanuela Formaggio, Mirko Avesani, Franco Milanese, Andrea Baraldo, Silvia Francesca Storti, Anna Gasparini, Roberto Cerini, Roberto Pozzi Mucelli, Antonio Fiaschi

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective: Whereas several studies have used functional magnetic resonance imaging (fMRI) to investigate motor recovery, whether therapy to decrease post-stroke hypertonus alters central motor patterns remains unclear. In this study, we used continuous electromyography (EMG)-fMRI to investigate possible changes in movement-related brain activation in patients receiving Botulinum toxin (BoNT-A) for hand-muscle hypertonus after chronic stroke. Methods: We studied eight stroke patients all of whom had hemiparesis and associated upper-limb hypertonus. All patients underwent an fMRI-EMG recording and clinical-neurological assessment before BoNT-A and 5 weeks thereafter. The handgrip motor task during imaging was fixed across both patients and controls. The movements were metronome paced, movement amplitude and force were controlled with a plastic orthosis, dynamometer and EMG recording. An age-matched control group was recruited from among healthy volunteers underwent the same fMRI-EMG recording. Results: Before BoNT-A, while patients moved the paretic hand, fMRI detected wide bilateral activation in the sensorymotor areas (SM1), in the supplementary motor area (SMA) and cerebellum. After BoNT-A blood oxygenation level-dependent (BOLD) activation decreased in ipsilateral and contralateral motor areas and became more lateralized. BOLD activation decreased also in ipsilateral cerebellar regions and in the SMA. Conclusion: Changes in peripheral upper-limb hypertonus after BoNT-A were associated to an improvement in active movements and more lateralized and focalized activation of motor areas. The clinical and EMG-fMRI coregistration technique we used to study hand-muscle hypertonus in patients receiving BoNT-A after chronic stroke should be useful in future studies seeking improved strategies for post-stroke neurorehabilitation.

Original languageEnglish
Pages (from-to)646-652
Number of pages7
JournalMagnetic Resonance Imaging
Volume28
Issue number5
DOIs
Publication statusPublished - Jun 2010

Fingerprint

Electromyography
Upper Extremity
Magnetic Resonance Imaging
Motor Cortex
Stroke
Chemical activation
Hand
Oxygenation
Muscle
Blood
Orthotic Devices
Muscles
Botulinum Toxins
Imaging techniques
Paresis
Dynamometers
Cerebellum
Plastics
incobotulinumtoxinA
Healthy Volunteers

Keywords

  • Botulinum toxin
  • EMG
  • FMRI
  • Spasticity
  • Stroke

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Biomedical Engineering
  • Medicine(all)

Cite this

Manganotti, P., Acler, M., Formaggio, E., Avesani, M., Milanese, F., Baraldo, A., ... Fiaschi, A. (2010). Changes in cerebral activity after decreased upper-limb hypertonus: An EMG-fMRI study. Magnetic Resonance Imaging, 28(5), 646-652. https://doi.org/10.1016/j.mri.2009.12.023

Changes in cerebral activity after decreased upper-limb hypertonus : An EMG-fMRI study. / Manganotti, Paolo; Acler, Michele; Formaggio, Emanuela; Avesani, Mirko; Milanese, Franco; Baraldo, Andrea; Storti, Silvia Francesca; Gasparini, Anna; Cerini, Roberto; Mucelli, Roberto Pozzi; Fiaschi, Antonio.

In: Magnetic Resonance Imaging, Vol. 28, No. 5, 06.2010, p. 646-652.

Research output: Contribution to journalArticle

Manganotti, P, Acler, M, Formaggio, E, Avesani, M, Milanese, F, Baraldo, A, Storti, SF, Gasparini, A, Cerini, R, Mucelli, RP & Fiaschi, A 2010, 'Changes in cerebral activity after decreased upper-limb hypertonus: An EMG-fMRI study', Magnetic Resonance Imaging, vol. 28, no. 5, pp. 646-652. https://doi.org/10.1016/j.mri.2009.12.023
Manganotti P, Acler M, Formaggio E, Avesani M, Milanese F, Baraldo A et al. Changes in cerebral activity after decreased upper-limb hypertonus: An EMG-fMRI study. Magnetic Resonance Imaging. 2010 Jun;28(5):646-652. https://doi.org/10.1016/j.mri.2009.12.023
Manganotti, Paolo ; Acler, Michele ; Formaggio, Emanuela ; Avesani, Mirko ; Milanese, Franco ; Baraldo, Andrea ; Storti, Silvia Francesca ; Gasparini, Anna ; Cerini, Roberto ; Mucelli, Roberto Pozzi ; Fiaschi, Antonio. / Changes in cerebral activity after decreased upper-limb hypertonus : An EMG-fMRI study. In: Magnetic Resonance Imaging. 2010 ; Vol. 28, No. 5. pp. 646-652.
@article{e7cd1e41ef024a72a378a1ab43867382,
title = "Changes in cerebral activity after decreased upper-limb hypertonus: An EMG-fMRI study",
abstract = "Objective: Whereas several studies have used functional magnetic resonance imaging (fMRI) to investigate motor recovery, whether therapy to decrease post-stroke hypertonus alters central motor patterns remains unclear. In this study, we used continuous electromyography (EMG)-fMRI to investigate possible changes in movement-related brain activation in patients receiving Botulinum toxin (BoNT-A) for hand-muscle hypertonus after chronic stroke. Methods: We studied eight stroke patients all of whom had hemiparesis and associated upper-limb hypertonus. All patients underwent an fMRI-EMG recording and clinical-neurological assessment before BoNT-A and 5 weeks thereafter. The handgrip motor task during imaging was fixed across both patients and controls. The movements were metronome paced, movement amplitude and force were controlled with a plastic orthosis, dynamometer and EMG recording. An age-matched control group was recruited from among healthy volunteers underwent the same fMRI-EMG recording. Results: Before BoNT-A, while patients moved the paretic hand, fMRI detected wide bilateral activation in the sensorymotor areas (SM1), in the supplementary motor area (SMA) and cerebellum. After BoNT-A blood oxygenation level-dependent (BOLD) activation decreased in ipsilateral and contralateral motor areas and became more lateralized. BOLD activation decreased also in ipsilateral cerebellar regions and in the SMA. Conclusion: Changes in peripheral upper-limb hypertonus after BoNT-A were associated to an improvement in active movements and more lateralized and focalized activation of motor areas. The clinical and EMG-fMRI coregistration technique we used to study hand-muscle hypertonus in patients receiving BoNT-A after chronic stroke should be useful in future studies seeking improved strategies for post-stroke neurorehabilitation.",
keywords = "Botulinum toxin, EMG, FMRI, Spasticity, Stroke",
author = "Paolo Manganotti and Michele Acler and Emanuela Formaggio and Mirko Avesani and Franco Milanese and Andrea Baraldo and Storti, {Silvia Francesca} and Anna Gasparini and Roberto Cerini and Mucelli, {Roberto Pozzi} and Antonio Fiaschi",
year = "2010",
month = "6",
doi = "10.1016/j.mri.2009.12.023",
language = "English",
volume = "28",
pages = "646--652",
journal = "Magnetic Resonance Imaging",
issn = "0730-725X",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Changes in cerebral activity after decreased upper-limb hypertonus

T2 - An EMG-fMRI study

AU - Manganotti, Paolo

AU - Acler, Michele

AU - Formaggio, Emanuela

AU - Avesani, Mirko

AU - Milanese, Franco

AU - Baraldo, Andrea

AU - Storti, Silvia Francesca

AU - Gasparini, Anna

AU - Cerini, Roberto

AU - Mucelli, Roberto Pozzi

AU - Fiaschi, Antonio

PY - 2010/6

Y1 - 2010/6

N2 - Objective: Whereas several studies have used functional magnetic resonance imaging (fMRI) to investigate motor recovery, whether therapy to decrease post-stroke hypertonus alters central motor patterns remains unclear. In this study, we used continuous electromyography (EMG)-fMRI to investigate possible changes in movement-related brain activation in patients receiving Botulinum toxin (BoNT-A) for hand-muscle hypertonus after chronic stroke. Methods: We studied eight stroke patients all of whom had hemiparesis and associated upper-limb hypertonus. All patients underwent an fMRI-EMG recording and clinical-neurological assessment before BoNT-A and 5 weeks thereafter. The handgrip motor task during imaging was fixed across both patients and controls. The movements were metronome paced, movement amplitude and force were controlled with a plastic orthosis, dynamometer and EMG recording. An age-matched control group was recruited from among healthy volunteers underwent the same fMRI-EMG recording. Results: Before BoNT-A, while patients moved the paretic hand, fMRI detected wide bilateral activation in the sensorymotor areas (SM1), in the supplementary motor area (SMA) and cerebellum. After BoNT-A blood oxygenation level-dependent (BOLD) activation decreased in ipsilateral and contralateral motor areas and became more lateralized. BOLD activation decreased also in ipsilateral cerebellar regions and in the SMA. Conclusion: Changes in peripheral upper-limb hypertonus after BoNT-A were associated to an improvement in active movements and more lateralized and focalized activation of motor areas. The clinical and EMG-fMRI coregistration technique we used to study hand-muscle hypertonus in patients receiving BoNT-A after chronic stroke should be useful in future studies seeking improved strategies for post-stroke neurorehabilitation.

AB - Objective: Whereas several studies have used functional magnetic resonance imaging (fMRI) to investigate motor recovery, whether therapy to decrease post-stroke hypertonus alters central motor patterns remains unclear. In this study, we used continuous electromyography (EMG)-fMRI to investigate possible changes in movement-related brain activation in patients receiving Botulinum toxin (BoNT-A) for hand-muscle hypertonus after chronic stroke. Methods: We studied eight stroke patients all of whom had hemiparesis and associated upper-limb hypertonus. All patients underwent an fMRI-EMG recording and clinical-neurological assessment before BoNT-A and 5 weeks thereafter. The handgrip motor task during imaging was fixed across both patients and controls. The movements were metronome paced, movement amplitude and force were controlled with a plastic orthosis, dynamometer and EMG recording. An age-matched control group was recruited from among healthy volunteers underwent the same fMRI-EMG recording. Results: Before BoNT-A, while patients moved the paretic hand, fMRI detected wide bilateral activation in the sensorymotor areas (SM1), in the supplementary motor area (SMA) and cerebellum. After BoNT-A blood oxygenation level-dependent (BOLD) activation decreased in ipsilateral and contralateral motor areas and became more lateralized. BOLD activation decreased also in ipsilateral cerebellar regions and in the SMA. Conclusion: Changes in peripheral upper-limb hypertonus after BoNT-A were associated to an improvement in active movements and more lateralized and focalized activation of motor areas. The clinical and EMG-fMRI coregistration technique we used to study hand-muscle hypertonus in patients receiving BoNT-A after chronic stroke should be useful in future studies seeking improved strategies for post-stroke neurorehabilitation.

KW - Botulinum toxin

KW - EMG

KW - FMRI

KW - Spasticity

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=77952959568&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952959568&partnerID=8YFLogxK

U2 - 10.1016/j.mri.2009.12.023

DO - 10.1016/j.mri.2009.12.023

M3 - Article

VL - 28

SP - 646

EP - 652

JO - Magnetic Resonance Imaging

JF - Magnetic Resonance Imaging

SN - 0730-725X

IS - 5

ER -